Chen Frederick M, Phillips Robert L, Schneeweiss Ronald, Andrilla C Holly A, Hart L Gary, Fryer George E, Casey Susan, Rosenblatt Roger A
Robert Wood Johnson Clinical Scholars Program, WWAMI Rural Health Research Center, Department of Family Medicine, University of Washington, USA.
Fam Med. 2002 Oct;34(9):663-8.
Medicare provides the majority of funding to support graduate medical education (GME). Following the flow of these funds from hospitals to training programs is an important step in accounting for GME funding.
Using a national survey of 453 family practice residency programs and Medicare hospital cost reports, we assessed residency programs' knowledge of their federal GME funding and compared their responses with the actual amounts paid to the sponsoring hospitals by Medicare.
A total of 328 (72%) programs responded; 168 programs (51%) reported that they did not know how much federal GME funding they received. Programs that were the only residency in the hospital (61% versus 36%) and those that were community hospital-based programs (53% versus 22%) were more likely to know their GME allocation. Programs in hospitals with other residencies received less of their designated direct medical education payment than programs that were the only residency in the sponsoring hospital (-45% versus +19%).
More than half of family practice training programs do not know how much GME they receive. These findings call for improved accountability in the use of Medicare payments that are designated for medical education.
医疗保险为支持毕业后医学教育（GME）提供了大部分资金。追踪这些资金从医院流向培训项目是核算GME资金的重要一步。
通过对453个家庭医学住院医师培训项目进行全国性调查，并结合医疗保险医院成本报告，我们评估了住院医师培训项目对其联邦GME资金的了解情况，并将他们的回答与医疗保险实际支付给主办医院的金额进行了比较。
共有328个（72%）项目做出了回应；168个项目（51%）报告称他们不知道自己获得了多少联邦GME资金。医院中唯一的住院医师培训项目（61%对36%）以及社区医院的住院医师培训项目（53%对22%）更有可能知道其GME拨款情况。与主办医院中唯一的住院医师培训项目相比，有其他住院医师培训项目的医院中的项目获得的指定直接医学教育支付较少（-45%对+19%）。
超过一半的家庭医学培训项目不知道自己获得了多少GME资金。这些发现呼吁在使用指定用于医学教育的医疗保险支付方面提高问责制。
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